Illinois General Assembly - Full Text of SR0063
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Full Text of SR0063  101st General Assembly




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2    WHEREAS, An estimated 700 to 900 women now die as a result
3of pregnancy and childbirth-related causes, and over 60 percent
4of the pregnancy-related deaths in the United States are
5preventable; and
6    WHEREAS, Illinois had more than 150,000 births in 2016 with
772 pregnancy-associated deaths and 985 infant deaths; and
8    WHEREAS, 72 percent of the pregnancy-related deaths and 93
9percent of violent-pregnancy-related deaths were deemed
10preventable in Illinois by review committees; and
11    WHEREAS, African American women in the United States
12experience maternal-related deaths at three to four times the
13rate of non-Hispanic white women, according to the Mothers and
14Offspring Mortality and Morbidity Awareness Act, introduced by
15U.S. Representative Robin Kelly of Illinois in May 2018; and
16    WHEREAS, Non-Hispanic black women are six times as likely
17to die of a pregnancy-related condition as non-Hispanic white
18women in Illinois, according to the Illinois Maternal Morbidity
19and Mortality Report; and
20    WHEREAS, The United States has not been able to submit a



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1formal maternal mortality rate to international data
2repositories since 2007, and, in order to be able to calculate
3a formal maternal mortality rate, maternal mortality-related
4data must be streamlined at the State level and extrapolated to
5the federal level; and
6    WHEREAS, Leaders in maternal wellness highly recommend
7that maternal deaths be investigated at the State level first;
9    WHEREAS, Among the top common causes of pregnancy-related
10deaths in Illinois are hemorrhage, infection, and hypertensive
11disorders of pregnancy; and
12    WHEREAS, The State of California has established Maternal
13Mortality Review Committees to determine the most prevalent
14causes of maternal mortality and recorded and shared data with
15providers and researchers, who have developed and implemented
16safety bundles and care protocols related to preeclampsia,
17maternal hemorrhage, and other prevalent causes of maternal
18mortality; and
19    WHEREAS, The Illinois Department of Public Health
20currently works with the Maternal Mortality Review Committee
21and the Maternal Mortality Review Committee for Violent Deaths
22to review cases of maternal death and to develop statewide



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1recommendations to prevent future maternal deaths; and
2    WHEREAS, In the State of California, state-based maternal
3quality collaborative organizations have formed obstetrical
4protocols, tool kits, and other resources to improve system
5care and response as they relate to maternal complications and
6warning signs for conditions such as maternal hemorrhage,
7hypertension, and preeclampsia; and
8    WHEREAS, Illinois has begun developing protocols and
9resources to address common causes of maternal mortality in the
10State, such as implementing new training material regarding
11hemorrhages through the Obstetric Hemorrhage Education Project
12(OBHEP) in 2016; and
13    WHEREAS, The CDC reports that more than half of all
14maternal deaths occur in the immediate postpartum period, which
15is between 42 days to a full year after delivery; yet, for
16pregnant women, Medicaid coverage lapses at the end of the
17month on which the 60th postpartum day lands; and
18    WHEREAS, Expanding Medicaid and CHIP coverage for pregnant
19and postpartum women has been a part of improving federal
20efforts for the prevention of maternal mortality; and
21    WHEREAS, Research has shown that, relative to white



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1patients, black patients are less likely to be given pain
2medications, and, when pain medication is given, they receive
3lower quantities; and
4    WHEREAS, A 2015 study from JAMA Pediatrics found that black
5children with appendicitis were less likely to receive pain
6medication than their white counterparts; and
7    WHEREAS, A study examining disparities in the triaging, or
8giving a degree of urgency to, pediatric emergency department
9patients concluded that black, Hispanic, and Native American
10patients received lower acuity triage scores than whites when
11presenting subjective complaints, such as breathing difficulty
12or abdominal pain; and
13    WHEREAS, Researchers have also documented an association
14between race and increased mortality from stroke, and others
15have found that minority patients are less likely to receive
16thrombolytics than white patients; and
17    WHEREAS, A study in the Proceedings of the National Academy
18of Sciences contributes bias in pain assessment and management
19of patients partially to the fact that about half of medical
20students and residents believed inaccurate biological
21differences between black and white people, including that
22black people have less sensitive nerve endings or that a black



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1person's blood coagulates more quickly, as well as other
2unconscious biases; and
3    WHEREAS, Biases in patient assessment and treatment affect
4the level of care for pregnant women, particularly women of
5color; and
6    WHEREAS, The provider pool is not primed with many people
7of color, nor are providers consistently required to undergo
8implicit bias, cultural competency, or empathy training on a
9consistent, on-going basis; and
10    WHEREAS, Studies have also shown that women are generally
11less likely to be diagnosed with diseases, such as heart
12disease, and are less likely to receive aggressive treatment
13for pain management and certain diseases than men; and
14    WHEREAS, There have been efforts to address implicit bias
15and cultural competency at the federal level by awarding
16cooperative agreements for the establishment or support of
17regional centers of excellence addressing implicit bias and
18cultural competency in patient-provider interactions for the
19purpose of enhancing and improving how health care
20professionals are educated in implicit bias and delivering
21culturally competent health care; therefore, be it



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2ASSEMBLY OF THE STATE OF ILLINOIS, that the State of Illinois
3recognizes the importance of investigating and addressing
4maternal mortality issues in the State; and be it further
5    RESOLVED, That we urge the General Assembly to investigate
6and identify areas in which the State can improve with respect
7to the prevention of maternal mortality, especially among
8vulnerable populations.